Seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China: A nationwide cohort study
BackgroundAcute kidney injury (AKI) is a severe clinical syndrome that places a massive burden on medical systems worldwide, yet the seasonality of AKI remains unexplored in China. The aim of this study was to describe the seasonal variation in the detection rate and all-cause in-hospital mortality...
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Frontiers Media S.A.
2022-10-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.947185/full |
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| author | Jiaqi Li Jiaqi Li Qingqing Zhou Qingqing Zhou Daoning Zhang Daoning Zhang Jinwei Wang Jinwei Wang Jinwei Wang Li Yang Li Yang Li Yang |
| author_facet | Jiaqi Li Jiaqi Li Qingqing Zhou Qingqing Zhou Daoning Zhang Daoning Zhang Jinwei Wang Jinwei Wang Jinwei Wang Li Yang Li Yang Li Yang |
| author_sort | Jiaqi Li |
| collection | DOAJ |
| description | BackgroundAcute kidney injury (AKI) is a severe clinical syndrome that places a massive burden on medical systems worldwide, yet the seasonality of AKI remains unexplored in China. The aim of this study was to describe the seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China based on a nationwide cohort study.MethodsThis was a retrospective cohort recruiting a national sample of 7,291 adult patients treated in hospitals in 22 provinces of mainland China during January or July 2013. AKI was defined according to the 2012 Kidney Disease Improving Global Outcomes AKI creatinine criteria or expanded criteria of increase or decrease in serum creatinine level of 50% during the hospital stay. The seasonal group was determined according to the corresponding admission date for each patient. The detection rate of AKI refers to the ratio of identified AKI cases to the total number of adult admissions from the same regional or seasonal group.ResultsBoth the detection rate (2.31 vs. 2.08%, p = 0.001) and in-hospital mortality rate (13.3 vs. 10.7%, p = 0.001) of AKI were higher in winter than in summer. The patients with AKI detected in winter had higher proportions of prehistory diseases, cardiac or vascular kidney injury factors, and severe comorbidities than those in summer (all p < 0.05). In the multivariable analysis, winter was an independent risk factor for in-hospital mortality of patients with AKI [odds ratio (OR) = 1.22, 95% confidence interval (CI), 1.03–1.44, p = 0.02] after adjusting for demographic factors, medical history, comorbidity, and climatic confounders. Higher ambient temperature (OR = 0.91, 95% CI, 0.86–0.97, p = 0.002, per 10°C increase), higher relative humidity level (OR = 1.14, 95% CI, 1.04–1.25, p = 0.005, per 10% increase), and living in temperate continental region (OR = 2.18, 95% CI, 1.63–2.91, p < 0.001) were each independently associated with in-hospital mortality.ConclusionThe detection rate and all-cause in-hospital mortality of AKI showed a winter predominance in patients with AKI in China. Winter appeared to be an independent risk factor for all-cause in-hospital mortality in patients with AKI. Environmental factors, including lower ambient temperature, higher relative humidity level, and living in temperate continental climatic regions, were each independently associated with increased risks of in-hospital mortality in patients with AKI. |
| first_indexed | 2024-04-12T03:39:09Z |
| format | Article |
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| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-12T03:39:09Z |
| publishDate | 2022-10-01 |
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| spelling | doaj.art-905422b495b346f7a9979894e9fb84ed2022-12-22T03:49:21ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-10-011010.3389/fpubh.2022.947185947185Seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China: A nationwide cohort studyJiaqi Li0Jiaqi Li1Qingqing Zhou2Qingqing Zhou3Daoning Zhang4Daoning Zhang5Jinwei Wang6Jinwei Wang7Jinwei Wang8Li Yang9Li Yang10Li Yang11Renal Division, Department of Medicine, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaRenal Division, Department of Medicine, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaRenal Division, Department of Medicine, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaRenal Division, Department of Medicine, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaResearch Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, ChinaRenal Division, Department of Medicine, Peking University First Hospital, Beijing, ChinaInstitute of Nephrology, Peking University, Beijing, ChinaResearch Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, ChinaBackgroundAcute kidney injury (AKI) is a severe clinical syndrome that places a massive burden on medical systems worldwide, yet the seasonality of AKI remains unexplored in China. The aim of this study was to describe the seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China based on a nationwide cohort study.MethodsThis was a retrospective cohort recruiting a national sample of 7,291 adult patients treated in hospitals in 22 provinces of mainland China during January or July 2013. AKI was defined according to the 2012 Kidney Disease Improving Global Outcomes AKI creatinine criteria or expanded criteria of increase or decrease in serum creatinine level of 50% during the hospital stay. The seasonal group was determined according to the corresponding admission date for each patient. The detection rate of AKI refers to the ratio of identified AKI cases to the total number of adult admissions from the same regional or seasonal group.ResultsBoth the detection rate (2.31 vs. 2.08%, p = 0.001) and in-hospital mortality rate (13.3 vs. 10.7%, p = 0.001) of AKI were higher in winter than in summer. The patients with AKI detected in winter had higher proportions of prehistory diseases, cardiac or vascular kidney injury factors, and severe comorbidities than those in summer (all p < 0.05). In the multivariable analysis, winter was an independent risk factor for in-hospital mortality of patients with AKI [odds ratio (OR) = 1.22, 95% confidence interval (CI), 1.03–1.44, p = 0.02] after adjusting for demographic factors, medical history, comorbidity, and climatic confounders. Higher ambient temperature (OR = 0.91, 95% CI, 0.86–0.97, p = 0.002, per 10°C increase), higher relative humidity level (OR = 1.14, 95% CI, 1.04–1.25, p = 0.005, per 10% increase), and living in temperate continental region (OR = 2.18, 95% CI, 1.63–2.91, p < 0.001) were each independently associated with in-hospital mortality.ConclusionThe detection rate and all-cause in-hospital mortality of AKI showed a winter predominance in patients with AKI in China. Winter appeared to be an independent risk factor for all-cause in-hospital mortality in patients with AKI. Environmental factors, including lower ambient temperature, higher relative humidity level, and living in temperate continental climatic regions, were each independently associated with increased risks of in-hospital mortality in patients with AKI.https://www.frontiersin.org/articles/10.3389/fpubh.2022.947185/fullacute kidney injury (AKI)seasonalitydetection ratein-hospital mortalityepidemiology |
| spellingShingle | Jiaqi Li Jiaqi Li Qingqing Zhou Qingqing Zhou Daoning Zhang Daoning Zhang Jinwei Wang Jinwei Wang Jinwei Wang Li Yang Li Yang Li Yang Seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China: A nationwide cohort study Frontiers in Public Health acute kidney injury (AKI) seasonality detection rate in-hospital mortality epidemiology |
| title | Seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China: A nationwide cohort study |
| title_full | Seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China: A nationwide cohort study |
| title_fullStr | Seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China: A nationwide cohort study |
| title_full_unstemmed | Seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China: A nationwide cohort study |
| title_short | Seasonal variation in the detection rate and all-cause in-hospital mortality of AKI in China: A nationwide cohort study |
| title_sort | seasonal variation in the detection rate and all cause in hospital mortality of aki in china a nationwide cohort study |
| topic | acute kidney injury (AKI) seasonality detection rate in-hospital mortality epidemiology |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.947185/full |
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